Diseases of the veins and large blood vessels are accompanied by significant changes in their physical condition, which negatively affect the quality of the blood circulation process. And varicose veins of the esophagus, which can significantly reduce the patient's quality of life due to the deterioration of the quality of digestion and blood flow in the body, require careful attitude and timely initiation of treatment. This pathology can be accompanied by the addition of secondary lesions of the digestive organs, or it can occur and proceed independently.
However, with any type of appearance, the dilated veins of the esophagus and varicose veins that subsequently develop are accompanied by unpleasant symptoms that allow you to identify the lesion in question at the initial stage of development and initiate a therapeutic effect in a timely manner, prevent the development of complications. Medical statistics note that this pathology of the esophagus veins occurs mainly in the male population (women are affected by varicose veins of the esophagus twice as rarely as men), while the average age at which the first manifestations can be noticed of the disease is 50-55 years.
Causes of the onset of the disease
The causes that cause the appearance of varicose veins of the esophagus can be different depending on the manifestation of the disease, the general condition of the patient's body, in any case the set of causes can vary. However, in any case, varicose veins occurring in the veins of the digestive organs are the result of a change in the general condition of the veins. The reason for the manifestation of varicose veins of such localization is excessively high blood pressure in the venous circulation, which is most often characteristic of liver cirrhosis.
And the result of such expansion can be massive bleeding, the danger of which lies in the absence of symptoms, which can be considered a warning: bleeding in esophageal varicose veins is often abundant, representing a real danger to the general condition of the patient . Therefore, knowledge of the manifestation of this pathology of the veins of the esophagus and measures to prevent the disease will allow to diagnose it earlier and begin an adequate therapeutic effect.
Also, the following conditions of the patient can be the causes of this pathological change in the veins of the digestive organs:
- congestion observed in the portal vein;
- portal thrombosis;
- development of malignant goiter;
- esophageal angioma.
Furthermore, the occurrence of the lesion in question can be caused by the symptoms and vascular pathologies that accompany Randu-Osler disease. All these diseases and conditions are accompanied by negative changes in the circulatory system and digestive organs, which initially affect the general condition of the veins and large arteries of the esophagus and stomach tissues. Changes in the circulatory system of internal organs such as the liver, spleen, gallbladder can provoke the development of varicose changes in the esophagus.
Symptoms of the patient
The main manifestation of a condition such as varicose veins located in the esophagus is bleeding. This symptom can be noticed in the absence of manifestations of alertness, against the background of the so-called "full health". A sign of impending bleeding can be considered a slight tickle in the throat, a characteristic taste of blood when swallowing (salty-sour). The blood that forms during bleeding during the development of varicose veins is usually pronounced bright scarlet, it can resemble coffee grounds. The result of this bleeding, which is often prolonged and profuse, is dizziness, a feeling of weakness, loss of consciousness.
Since the causes of aggravation of varicose veins can be a variety of injuries to internal organs and the circulatory system as a whole, the overall quality of the functioning of these organs is largely determined by both the likelihood of developing varicose veins and the symptoms that may accompany this injury.
A symptom of the considered pathological change in the digestive organs can be considered bleeding, which develops during the asymptomatic course of the initial manifestations of the disease. Such bleeding can be both insignificant, which does not immediately attract the patient's attention, and profuse, which has a high risk of death. Varicose veins, which are noted in the tissues of the esophagus and stomach, are often characterized by the absence of significant changes that allow for timely detection and treatment. However, this disease is one of the most formidable: with unexpected bleeding, characterized by an abundance of released blood, there is a high probability of death for the patient. According to medical statistics, out of five cases of manifestation and aggravation of varicose veins in the digestive organs, four are the death of the patient.
Types and degrees of varicose veins of the esophagus
Today, experts distinguish different degrees of development of esophageal varicose veins, each of them has its own developmental features, differs in the list of manifestations and requires a certain therapeutic effect, which allows you to prevent further aggravation of the pathology. Thanks to modern diagnostic methods, it becomes possible to determine the presence of the disease, its stage and degree of development.
There are the following degrees of enlargement of the stomach veins and varicose veins:
- the first degree, in which there is a slight change in the lumen of the organ veins. Varicose veins of the esophagus, characteristic of grade 1, may not be noticed by the patient, since he rarely has a definite and pronounced symptomatology. The veins of the esophagus have an average lumen of 5 mm, which is not very different from their state of health. However, even with this size, they become less elastic, since even small changes in their lumen lead to a certain decrease in the intensity of blood movement along them, the overall quality of blood circulation in the affected organ is disturbed. Varicose veins of the esophagus of 1 degree can be detected during a preventive examination of this organ;
- the second degree is characterized by an increase in the lumen of the veins in the diseased organ up to 10 mm, the speed of blood flow through the veins gradually decreases, which adversely affects the condition of the veins: they continue to lose their elasticity, the walls gradually thin, which can cause bleeding due to the high probability of their rupture;
- at the third stage of aggravation of the pathology, there is an expansion of the lumen of the veins in the esophagus and stomach by more than 10 mm, the vessels, due to their expansion, are located close to each other, and also the their slight trauma can cause bleeding. Often it is in the third stage of the development of the disease that severe bleeding is noted, which causes the patient's death, is a real danger to the life of a sick person suffering from varicose veins in the tissues of the digestive organs.
The above classification of varicose veins of the esophagus allows us to classify the existing lesion of the veins of this organ to a certain extent and start treatment, which has a positive effect on the patient's condition. Treatment of esophageal varicose veins should be chosen by a doctor who, on the basis of studies and analysis of the patient's general condition, chooses both the exposure scheme and the exposure variant, taking into account the characteristics of his organism.
Varicose veins of the stomach
The expansion of the veins, due to a negative change in their condition, can also be observed in the stomach. In this case, just as in the case of esophageal varicose veins, a gradual decrease in the degree of elasticity of the vein walls occurs, with the occurrence of a significant likelihood of bleeding. Modern diagnostic methods make it possible to detect the pathology in question in time and begin its treatment.
The methods of treating varicose veins, which are localized in the tissues of the stomach, differ, but all of them are aimed at eliminating the root cause of this condition. The National Chemistry Center of the Russian Academy of Medical Sciences provides such data on the causes and methods of treatment of varicose veins in both the esophagus and stomach:
- treatment of the manifestations of varicose veins in the esophagus and stomach according to the method described in the book of leading experts in gastroenterology, the differentiation of the identified disease of the digestive organ is performed and this technique and a detailed description of the manifestations of such rare lesions as pathologies operated esophagus, difficult-to-diagnose diseases of the digestive organs provide the greatest amount of information necessary to draw up a scheme of therapeutic effects for both therapists and narrow specialist gastroenterologists;
- Zdenek Marzhatka, one of the leading specialists in the field of gastroenterology and diseases of the esophagus, accompanied by damage to the veins in his tissues, describes in detail in his writings various methods of diagnosing the disease, types of endoscopy of the tissues of the stomach and the esophagus.
Today, to prevent further aggravation of the existing pathology, more and more modern diagnostic methods are used, aimed at a more detailed study of the state of the tissues of the affected digestive organs.
Diagnosis of the disease
Methods and options for diagnosing varicose veins that have formed in the digestive organs (esophagus and stomach) include the following manipulations and diagnostic procedures:
- Fibroesophagoscopy, which allows you to identify the cause of the bleeding. Also, this method allows you to determine the presence of mechanical causes for the occurrence of bleeding, the condition of the walls of the veins of the esophagus.
- X-ray of the walls of the esophagus, which is more informative when using contrast.
Both options for diagnosing the disease in question have the ability to detect the cause of bleeding, determine the condition of the walls of the veins and the likelihood of rupture of existing aneurysms. The use of both diagnostic options allows, with maximum accuracy, not only to detect the pathology of the veins and vessels of the esophagus and stomach, but also to obtain the greatest amount of information available on the pathology.
Possible complications
Since varicose veins occurring in the tissues of the esophagus and stomach are especially dangerous due to the likelihood of bleeding, it is necessary to take into account the possible complications of this pathology. Significant damage to the digestive organs, aggravation of liver cirrhosis are the most dangerous consequences of this pathology of the veins.
Methods of treatment
The therapeutic effect to eliminate the risk of bleeding in case of damage to the veins of the esophagus and stomach should take into account the stage of the pathological process, the general health of the patient, the susceptibility of his body to the ongoing therapeutic effect. Modern medicine is constantly improving the methods of influencing the veins of the esophagus, which allows you to quickly get rid of the most noticeable manifestations of the pathology in question.
Today, an integrated approach is used in the treatment of the considered pathology of the esophagus and stomach veins, which consists of a traditional, surgical and medical method of exposure. Each method has its own characteristics, can be used for certain indications and is prescribed by a doctor. The course of treatment must be monitored at all stages by the attending physician, who, if necessary, will promptly make the necessary adjustments and prevent the probable risks of complications.
traditional method
First of all, when using the traditional treatment option for esophageal varicose veins, the bleeding is stopped, which can be fatal. This will also allow for additional methods of therapeutic action, which will ensure faster regeneration of damaged tissues and create the necessary scar at the site of the lesion of the esophageal vein.
In order to compensate for hypovolemia and prevent the occurrence of hemorrhagic shock, a significant dose (calculated by the doctor) of vitamin K is introduced into the patient's body, as well as frozen plasma infusions (1-2 doses, intravenous transfusion is performed ).
Conservative method
With severe bleeding, which becomes a real danger to the patient's life, a rubber balloon can be used to quickly stop the bleeding. With the help of a probe, the bleeding vessel is pressed, which stops the movement of blood. For example, the probe of such a device - the Sengstaken-Blackmore probe is popular for eliminating bleeding during the development of varicose veins in the digestive organs, especially in the esophagus. Corrugated varieties of such probes are also used, which are widely used in the treatment of esophageal varicose veins with bleeding and bleeding gastric ulcers.
With the introduction of the probe under the site of the rupture of the vein, the esophagus can be washed with warm water at a temperature of 40 ° C - this measure often stops active bleeding and stabilizes the patient's condition. However, with repeated bleeding and at their high intensity, in parallel with the use of probes, it is recommended to carry out intravenous and intramuscular administration of substances that also contribute to blood arrest. Calcium chloride 10-20 ml is administered intravenously. Do not use for the introduction of drugs whose action is aimed at increasing blood pressure.
Treatment with an endoscope
Since this disease of the veins of the esophagus is often diagnosed during endoscopic examination, endoscopic hemostasis can be prescribed to eliminate the most characteristic manifestations of the lesion (elimination of bleeding). This method involves stitching the affected areas of the veins in the esophagus, and it is this variant of the therapeutic effect that is preferable to injection sclerotherapy due to the more pronounced positive dynamics of the treatment.
Carrying out endoscopic treatment is characterized by a rapid stop of bleeding, prevention of probable relapses of the disease. The drug, used in the implementation of endoscopic treatment of bleeding in varicose veins of the esophagus and stomach, is administered intravenously at 50 mcg, its action is aimed at increasing visceral vascular resistance, which allows to stabilize the condition of the patient, preventing excessively active blood loss. This drug is preferred over other drugs that can be given to stop venous bleeding from the esophagus because it has fewer side effects, even with long-term use.
The use of an endoscope involves the use of a special endoscopic examination of the esophagus, which is often prescribed for bleeding, the cause of which is unclear. This technique is very popular due to the high efficiency of this diagnostic method and the good positive dynamics of the treatment (ligation is performed), performed using an endoscope. Endoscopic examination of the veins of the esophagus and stomach has shown itself well at any stage of the development of the pathological process; In addition, this method allows you to detect even the initial manifestations of diseases of the digestive system in connection with blood circulation in the veins and to identify varicose veins of the esophagus.
The use of balloon tamponade
The endoscopic method of exposure also involves the use of such a variant to stop bleeding from the veins of the esophagus, such as balloon tamponade. It consists in the impact on the site of damage to the vein of special obturating agents. However, in the case of severe bleeding, balloon tamponade may not be very effective; Additional drugs should be used to stimulate regenerative processes in the tissues of the walls of the veins.
The classification that is proposed today for the division of varicose veins of the esophagus and allows to determine the most effective scheme of therapeutic effects. Taking into account the peculiarities of the stage of the current pathological process, the body's perception of the drugs used and the control of the ongoing treatment gives the attending physician the opportunity to make timely changes and achieve the best results in stopping bleeding and stabilizing of the patient's condition.
Surgical intervention
Heavy bleeding, which poses a threat to the patient's life due to significant blood loss, may require surgery.
Surgical intervention can be prescribed for large blood losses, in which intravenous administration of plasma, blood and blood replacement fluids does not bring a pronounced positive result. There are several types of surgery for significant blood loss. Each of them is prescribed according to its indications determined by the doctor.
Today, the following types of surgery are recognized as the most effective:
- imposition of a special medical rubber bandage. Such ligation of damaged veins allows you to quickly stop blood circulation, stop blood loss, which can cause a significant deterioration in the patient's condition;
- an operation such as bypass surgery leads to a decrease in blood pressure in the veins and, as a result, stops the bleeding. During the shunt, the liver tissue is affected, a special stent is inserted in the center of this organ, which creates a kind of bridge between the liver tissues and the esophagus tissues, which lowers blood pressure. The hepatic and portal veins, having such a "bridge", receive reduced pressure, which leads to the arrest of bleeding;
- Splenorenal shunt is a type of bypass surgery that helps prevent possible bleeding when varicose veins are detected in the tissues of the esophagus and stomach.
The listed options for surgery allow you to eliminate the increased blood pressure in the veins of the esophagus damaged by varicose veins. All of them are performed under the control of X-rays and provide the maximum positive effect from manipulations to stop bleeding.
Medical treatment of varicose veins
There is also a variant of the medicinal effects on the body to treat the initial stage of esophageal varicose veins. The choice of the type of drug is determined by the doctor after examining the patient's body, determining the stage of the current pathological process. When carrying out this type of therapy, indicators such as the susceptibility of the patient's body to the drug used, the likelihood of developing allergic reactions should be taken into account.
The most commonly used in the treatment of this disease are the following drugs with a pronounced effect on the veins:
The listed drugs have a number of possible side effects that should be considered when prescribing them.
Treatment with folk remedies
The reliability of drugs and methods of traditional medicine has been tested for centuries, but its effectiveness is not high enough to independently cope with the manifestations of varicose veins of the esophagus. Traditional medicine can be used as a maintenance drug, to increase the speed of recovery processes in the tissues of the veins. For example, with a high probability of bleeding, it is recommended to take decoctions and infusions of herbs that have a hemostatic effect. They can be harvested from nettle, thyme, highland bird.
Treatment with folk remedies is also possible at home, which is especially important for maintenance therapy of the disease, in the phase of remission. Since varicose veins of the esophagus are a serious injury, which poses a serious danger to the health and life of the patient, it is necessary to take into account the degree of impact of the selected traditional medicine. Treatment at home is carried out under the constant supervision of a doctor.
You need a diet
When diagnosing varicose veins in the digestive organs, the question of choosing a diet should be considered one of the most important, since it is on the food that enters the patient's body that both his well-being and the indicators of the effect largely depend therapeutic in progress. The recommended diet for varicose veins of the esophagus provides for the observance of some practicable rules, which provide for the exclusion of certain foods and the inclusion in the daily menu of some products that treat the body as a whole and the esophagus in particular.
The diet for varicose veins of the esophagus should exclude the following foods and substances from the patient's diet:
- seasonings;
- a large amount of table salt;
- excessive amounts of oils, especially of animal origin;
- fried, canned and smoked foods, which irritate the tissues of the esophagus and can cause bleeding.
Nutrition for varicose veins of esophageal tissues, as well as for cirrhosis of the liver, should include more boiled and stewed food, fermented milk products will perfectly support the necessary microflora in the intestine, without creating an excessive load on the apparatus digestive as a total. Fractional feeding in small portions, controlling the number of calories to prevent excessive effects on the digestive system will prevent the aggravation of the existing pathology and maintain the health of the esophagus.
Disease prevention methods
As a preventive measure for varicose veins, it is imperative to exclude bad habits, including smoking, drinking alcohol, junk food from fast food.
Regular examinations by a gastroenterologist will help identify the disease of the veins even at the initial stage of the development of the pathology and begin its treatment.
A healthy lifestyle
Maintaining a healthy lifestyle should be mandatory for those looking to maintain a healthy digestive system.
The prevention of diseases of the veins, the use of vitamin preparations to maintain a high level of immunity and examinations by a doctor are important components of success.
Exercise
To maintain the tone of the veins, to maintain the proper functioning of the digestive system, you should regularly take the necessary minimum of physical exercise.
Walking, light jogging, physical therapy exercises can be considered good preventive measures in the development of varicose veins.